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BCG and Other Vaccines
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Vaccination with BCG may confer protection against non-tuberculous mycobacterial species due to cross-reactivity with conserved, often immunodominant, antigens.58 The estimates of protective efficacy against leprosy, caused by Mycobacterium leprae, vary from 20% to 90%.45,59 Although one meta-analysis determined an overall BCG-vaccine protective effect of 41% (95% CI 16–66) for trials and 60% (95% CI 51–70) for observational studies,60 another analysis reported just 26% (95% CI 14–37) and suggested that protection had been overestimated in observational studies.61 Cross-protection of BCG against Buruli ulcer disease has been reported in some studies62,63 but not in others.64,65 Murine studies have demonstrated a protective effect of BCG against infection with Mycobacterium avium and Mycobacterium kansasii.66 A study of neonates in the Czech Republic found that M. avium intracellulare complex-associated lymphadenitis was lower in BCG-vaccinated compared with unvaccinated children.38
Respiratory infections
Published in Louis-Philippe Boulet, Applied Respiratory Pathophysiology, 2017
Several MOTT (mycobacteria other than tuberculosis) are present in the environment but most are human saprophytes. Some of these bacteria can, however, produce clinical infections and the ones most commonly associated with lung disease are Mycobacterium avium-intracellulare and Mycobacterium Kansasii. These infections can occur in individuals without systemic risk factors but who have bronchiectasis or cystic fibrosis [27,28].
Clarithromycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Mycobacterium kansasii exhibits in vitro sensitivity to clarithromycin. The rifampicin–ethambutol–clarithromycin regimen yielded a 100% cure rate in one small cohort study (Shitrit et al., 2006). However, there is better evidence for rifampicin, isoniazid, and ethambutol combination therapy in the treatment of Mycobacterium kansasii infection (Griffith et al., 2007).
Antimicrobial susceptibility and minimum inhibitory concentration distribution of common clinically relevant non-tuberculous mycobacterial isolates from the respiratory tract
Published in Annals of Medicine, 2022
Guiqing He, Lianpeng Wu, Qingyong Zheng, Xiangao Jiang
Mycobacterium kansasii lung disease has a higher success rate of treatment and a relatively lower degree of drug resistance than the first two lung diseases. International guidelines [1] have recommended triple-combination drugs, such as azithromycin (or clarithromycin), rifampicin (or rifabutin), ethambutol or isoniazid as the preferred choice for M. kansasii pneumonia. The antibacterial activity of the drugs in the standard triple regimen was found to be strong in this study, implying that the success rate of treatment for M. kansasii lung disease may be high. The drug resistance rate of ethambutol was 42.9%, and the MIC50/MIC90 was 2/16 μg/mL, suggesting poor antibacterial activity. However, ethambutol was preferred as an accompanying drug in the standard rifampicin-containing regimen in international guidelines [1]. The third edition of the CLSI drug sensitivity guidelines [33] removed the sensitivity breakpoint and gave only MIC for clinical reference; considering the poor reproducibility of ethambutol drug sensitivity and the uncertainty of the correlation between in vitro MIC and in vivo efficacy, this may be misleading to the clinic. Overall, M. kansasii pneumonia is susceptible to most antimicrobial drugs, with strong antimicrobial activity and a high cure rate.
STAT1 and STAT3 mutations: important lessons for clinical immunologists
Published in Expert Review of Clinical Immunology, 2018
Peter Olbrich, Alexandra F. Freeman
A recently diagnosed case illustrates nicely the above. The patient presented at age 3 years with limps and bone pain. Imaging revealed destructive lesions in the right iliac bone, right superior pubic ramus, left calcaneus, and distal left tibia. Biopsy showed granulomatous osteomyelitis with cultures positive for Mycobacterium kansasii. Combined antimycobacterial treatment resulted in a rapid improvement and antibiotics were stopped after 1 year maintaining azithromycin prophylaxis. Immunologic work-up was normal, and a heterozygous mutation in STAT1 (c.2017A>G) was detected. His asymptomatic identical twin brother was found to also carry this mutation and he was subsequently started on azithromycin prophylaxis (Freeman AF, personal communication).
State-of-the-art treatment strategies for nontuberculous mycobacteria infections
Published in Expert Opinion on Pharmacotherapy, 2020
Maria-Carmen Muñoz-Egea, Nerea Carrasco-Antón, Jaime Esteban
Despite the increasing number of recently developed antibiotics, as described above, there are still many issues that need to be solved to achieve better of patients with NTM diseases. More possibilities for the development of new molecules with activity against NTM are being studied. In this sense, the antimycobacterial activity of Micromeria barbata, Eucalyptus globulus, and Juniperus excelsa essential oils extracted from Lebanese plants was investigated against selected Mycobacterium spp. strains including Mycobacterium tuberculosis subsp. tuberculosis, multidrug-resistant M. tuberculosis, Mycobacterium kansasii, and Mycobacterium gordonae. All tested essential oils showed high antimycobacterial activity against targeted strains. Their data showed that M. barbata, E. globulus, and J. excelsa essential oils totally inhibit mycobacterial growth. This is the first study regarding the antimycobacterial activity of essential oils, and shows promising results, which encourages more investigation on these medicinal plants, especially M. barbata [114]. Currently, the anti-Mycobacterium ulcerans activity of some plants has been scientifically confirmed, including Ficus binjamina, Ficus elastica, Ficus saussureana, and Terminalia superba. Extracts of these plants have become important therapeutic developments in the treatment of Buruli ulcer [115]. Other anti-Mycobacterium ulcerans compounds are derived from Sorindeia juglandifolia and Holarrhena floribunda [116]. These studies show that natural products represent potential alternatives to standard therapies for use as curative medicine for M. ulcerans disease.